A bioengineered chewing gum formulation reduced levels of three microbes associated with head and neck squamous cell carcinoma and had minimal effects on selected commensal oral bacteria. (All images: Kevin Monko/Penn Dental Medicine)
PHILADELPHIA, US: Oral and oropharyngeal cancers remain a significant clinical challenge, and growing evidence has linked the oral microbiome to head and neck squamous cell carcinoma (HNSCC) development, progression or recurrence. Researchers at the University of Pennsylvania School of Dental Medicine have investigated whether a plant-based chewing gum formulation can reduce HNSCC-associated oral pathogens. The findings suggest that this approach could eventually be explored as a locally delivered adjunct for lowering microbial risk factors associated with oral and oropharyngeal cancer.
One part of the study focused on whether the chewing gum could reduce oral levels of human papillomavirus (HPV). Explaining the rationale for targeting HPV, lead researcher Dr Henry Daniell, W.D. Miller Professor and vice-chair of the Department of Basic and Translational Sciences at Penn Dental Medicine, told Dental Tribune International: “The global increase in oropharyngeal cancer has been linked to HPV-16, a high-risk type of HPV. When HPV integrates into human genome, it can initiate carcinogenic changes. Therefore, it is important to reduce or eliminate circulating HPV before integration.”
Dr Henry Daniell, W.D. Miller Professor and vice-chair of the Department of Basic and Translational Sciences at the University of Pennsylvania School of Dental Medicine in the US.
The research team collected saliva and oral rinse samples from patients with HNSCC and exposed these in the laboratory to extracts prepared from the chewing gum. The chewing gum formulation contained a protein derived from lablab beans that can bind to viruses and trap them, helping prevent their entry into host cells. This antiviral effect significantly reduced the detectable amount of HPV in the samples.
The researchers then optimised the chewing gum formulation by adding an antimicrobial peptide, seeking to target Porphyromonas gingivalis and Fusobacterium nucleatum, oral bacteria that have been implicated in oral cancer and HNSCC progression and survival outcomes. In ex vivo experiments, they found that the formulation reduced the concentration of both bacteria in saliva and oral rinse samples by more than 99%. The study also reported only minimal effects on selected non-pathogenic oral bacteria.
According to Prof. Daniell, the next step is clinical evaluation after regulatory authorisation. “Based on the successful reduction of these pathogens in ex vivo clinical studies, we plan to advance antiviral and antibacterial chewing gums for evaluation in HNSCC patients after authorisation by the US Food and Drug Administration of an investigational new drug application,” he said.
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